| Entity Name: | PEDIATRIC DENTAL SURGICAL ASSOCIATES PLLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Goodstanding |
| Date Formed: | 03 Jan 2019 |
| Company Number: | LLC_07140444 |
| File Number: | 07140444 |
| Type of Management: | Manager Managed |
| Date Status Change: | 10 Dec 2024 |
| Address | 2550 W. ADDISON STREET, CHICAGO, 60618, IL |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PEDIATRIC DENTAL SURGICAL ASSOCIATES 401(K) PLAN | 2023 | 833021248 | 2024-05-02 | PEDIATRIC DENTAL SURGICAL ASSOCIATES | 3 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-02 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7733775658 |
| Plan sponsor’s address | 2550 W ADDISON ST, CHICAGAO, IL, 60618 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-27 |
| Name of individual signing | CHRISTINE RIMER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| TODD L. ERDMAN, ESQ., 127 S. WHEELING RD., WHEELING, 60090 | Agent | 2019-01-03 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| KUTTAB, DDS, H. JOHNNY IBRAHIM, 2550 WEST ADDISON STREET, CHICAGO, IL, 60618 | Manager | 2024-12-10 |
Date of last update: 16 Jan 2025
